In industrialized countries the average life expectancy has continuously increased during the last decades and this trend is expected to continue. In Switzerland, a sexagenarian now has a 50% chance, if male, and 70% if female of reaching the age of 80. By 2050, the population of over 80 year-olds will have multiplied 2.7 times in Switzerland. Age is considered the greatest single risk factor for developing cancer, bladder cancer is no exception and typically affects old patients with a median age at the time of diagnosis of around 70. In the US 32% of patients diagnosed with bladder cancer are between 75 and 84. In addition, the prevalence of comorbidities in this old population is very high as hypertension is present in 50-60%, coronary artery disease in 15%, cardiac failure in 15%, dementia in 30%, diabetes in 10-20%, hearing and vision loss in 20-30%. The presence of advanced age, several comorbidities, new acute medical condition (i.e. fracture or newly diagnosed cancer) define the clinical condition of frailty. This medical condition is a consequence of age-related decline in many physiological systems, with defects accumulating with the passage of time (age) resulting in an increased risk of death (ageing).